Provider Demographics
NPI:1548500523
Name:LINDBERG, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:LINDBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9239 GROSS POINT RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-1389
Mailing Address - Country:US
Mailing Address - Phone:847-676-4447
Mailing Address - Fax:847-676-4450
Practice Address - Street 1:9239 GROSS POINT RD
Practice Address - Street 2:SUITE 300
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1389
Practice Address - Country:US
Practice Address - Phone:847-676-4447
Practice Address - Fax:847-676-4450
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-27
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007535101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional